The Chief Executive Officer of the National Health Insurance Authority (NHIA), Dr. Victor Asare Bampoe, has announced that the Scheme has made claims payments exceeding GH₵1 billion.
He disclosed this when he called on the World Health Organization (WHO) Ghana Country Director, Dr. Fiona Braka, and her team at the country Office in Accra.
During the engagement, Dr. Bampoe explained that the NHIA currently processes and pays claims within 21 to 30 days, underscoring the Authority’s commitment to operational efficiency and financial accountability.
He further highlighted ongoing efforts to eliminate fraudulent claims, reduce out-of-pocket payments, and improve Scheme performance for the benefit of both members and healthcare service providers.
Dr. Bampoe also outlined the objectives of the Free Primary Healthcare Initiative, describing it as an integrated approach combining diagnostic services and social behavioral change interventions to improve national health outcomes.
He expressed gratitude to Dr. Fiona Braka and her team for the fruitful engagement and reiterated the NHIA’s readiness to deepen collaboration with the WHO in support of Ghana’s broader health sector development goals.
Key Reform Milestones
The meeting also served as a platform for NHIA officials to provide updates on key reforms across various directorates.
Dr. Mrs. Ruby Aileen Mensah Annan, Director for Strategic Health Purchasing, acknowledged the persistent challenge of out-of-pocket payments but noted that recent tariff adjustments are expected to mitigate the issue significantly.
Dr. Abigail Derkyi-Kwarteng, Acting Director for Claims, reported that claims processing has fully transitioned from manual to digital systems, enhancing both speed and accuracy in processing reimbursements.
Mr. Magnus Owusu-Agyemang, Director of the Actuarial Directorate, explained that comprehensive financial impact assessments are conducted before introducing any new benefit packages under the Scheme. He emphasized the importance of financial sustainability in benefit expansion.
Ms. Mariam Musah, Deputy Director for the Strategic Health Purchasing Directorate, stated that the Free Primary Healthcare and Mahama Care initiatives are still under development. She noted that the ongoing stakeholder consultations would ensure inclusivity and effective policy design.
On member engagement, Mr. Oswald Essuah-Mensah, Acting Director for Corporate Affairs, emphasized that the NHIA is intensifying public education efforts to better inform members about their rights and entitlements under the Scheme.
Dr. Bampoe added that the Authority will increase advocacy to strengthen awareness of NHIS benefits and promote informed member participation.
WHO Commends Ghana’s Health Sector Progress
Dr. Fiona Braka applauded Ghana’s significant strides in health sector transformation and reaffirmed the WHO’s commitment to strengthening collaboration with the NHIA and other key stakeholders.
During the meeting, Dr. Sofonias Lareef, WHO Health Systems Coordinator, presented WHO’s perspective on aligning Ghana’s health financing strategies.
He expressed the organization’s interest in harmonizing the Ghana Medical Trust Fund with the NHIA and aligning it with the Free Primary Healthcare framework to ensure a more cohesive health financing structure.
He emphasized the WHO’s overarching mission to promote, provide, and protect public health.
Dr. Adwoa Twumwaah Twum-Barimah, Technical Officer for Health Financing, recommended integrating the National Health Insurance Scheme, the Free Primary Healthcare Initiative, and the Mahama Care program to ensure seamless policy alignment and sustainable implementation.
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